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HomeMy WebLinkAbout030-1096-10-020 c�cAO 3- o d o y f c to 7 �D 7 A. C D � � v M c :: d � � n co � 0 = z °o�' NNW �!• l o w CD o o N y 7 'CD C9 W� �w �n CL y > > 0 .) p v cn v ID e� a CD w (D A N d Q a O c ° 3 0 ° ° ( 0 CD W O N.. 0- -< N N v C' O C) fir. C lei N d C N N 3 .. CL z m O 00 ° �. l�l cA U < to z o `+f n' =r D �� CA fA (n p Fo = W N = 3 d D. W _ !D y cD z 3 a of N z z z O D 7 0 v 0 y C N N N G ca d a 3 a F z (D <p to p C A Z CD W N C m ° -+ z CD I W� D N) CD °O a w� oa 0 CL o °. CD m n @ m I o LO CD CD CL N y 7 0 ' A � N o y go n 90 ° C N O (D C C CD A O O 40 A W fA 0 ti V ° CD 6 CD O C- y Parcel #: 030 - 1096 -10 -400 03/01/2005 08:22 AM PAGE 1 OF 1 Alt. Parcel #: 32.30.19.350E 030 - TOWN OF SAINT JOSEPH Current XI ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): ' = Current Owner JEANETTE H TRUSTS DILTS ' DILTS, JEANETTE H TRUSTS 1218 TROUT BROOK RD N HUDSON WI 54016 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description SC 2611 SCH D OF HUDSON SP 1700 WITC Legal Description: Acres: 3.528 Plat: 1090 -CSM 14/3902 SEC 32 T30N R19W SW SW BEING LOT 4 CSM Block/Condo Bldg: LOT 4 14/3902 Tract(s): (Sec- Twn -Rng 401/4 1601/4) 32- 30N -19W SW SW Notes: Parcel History: Date Doc # Vol /Page Type 03/13/2000 619592 1495//327 WD 07/23/1997 1230/193 QC 2004 SUMMARY Bill #: Fair Market Value: Assessed with: 5617 89,000 Valuations: Last Changed: 07/08/2004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 3.530 87,600 0 87,600 NO Totals for 2004: General Property 3.530 87,600 0 87,600 Woodland 0.000 0 0 Totals for 2003: General Property 3.530 51,500 0 51,500 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch #: Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division t INSPECTION REPORT Sanitary Permit No: 405118 0 GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: City Village X Township Parcel Tax No: Knucitson, Steven & Deborah I St. Joseph Township 030 - 1096 -10 -000 CST BM Elev: Insp. B Elev: BM Description: vv o TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic / , , - /Ob U Ben ark If ' w r Dosing Alt: Aeration Bldg. Sewer 3 x G � I Holding__ -- SUHt Inlet ors -/ t` TANK SETBACK INFORMATION SUHt Outlet TANK TO P/L WELL IB Vent to Air Intake ROAD Dt Inlet Septic U , j /1 r , Dt Bottom > jV �--- Dosing t/ J Header /Ma C) Aeration ist. Z �3 9 8 Holding Bot. System 5 b�� PUMP /SIPHON INFORMATION Final Grade •� Rte' Manufacturer and St Cover / j _.. GPM ►�7Z aD 3J Model Number tq--Z �5.. TDH Lift Fri �oss System Head TDH t t Forcemain Length Dia. IDist. to Well �t T JY1 '7, o SOIL ABSORPTION SYSTEM BED /TRENCH Width , Length No. Of Trenches PIT DIMENSIONS FNo.Of Pits Dia. Liquid Depth DIMENSIONS jjI SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM ACHIN u er: r �� INFORMATION MBER -/7 Ty Of System: - c ! ` I t 7Ajyl✓ �/ odeLNumber: l DISTRIBUTION SYSTEM o2tt d dt+irr r L'ws' , Header /Manifold IDistribution Hole Size x Hole Spacing e t t Air�Inttake P'ps) � Spac � J l `�`' L Len g th Dia -J SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only Depth Over Depth Over xx Depth of xx Seeded /Sodded xx Mulched Bed/ Trench C enter �y Bed/Trench Edges Topsoil Yes L ] No Yes �No Z COMMENTS: (Include code discrepencies persons present, etc.) Inspection #1: / 2 � — Inspection #2: Location: 1217 Trout Brook Road No. Hudson WI 54016 SW 1/4 SW 1/4 32 T30N R1 9W) NA Lot 5 Parcel No: 32.30.19.350A 1.j Alt BM Description = ST VE�� 6 2.) Bldg sewer length = q0 CCk - cc Yhc 5 &il - amount of cover Plan revision Required? ' es No 1 Use other side for additional information. SBD -6710 (R.3/97) Date Insepctor's Signatu a Cert. No. Safety and Buildings Division County _ �i 201 W. Washington Ave„ P.O, Box 7162 i scon5'in Madison, WI 53707 - 7162 Sanitary Permit Number (to be tilled in by Co.) Department of Commerce (608) 266-3151 JL S / l Sanitary Permit Application State Plan I.D. Number , /V In accord with Comm 83.21, Wis. Adm. Code, personal infor vide may be used for secondary purposes Privacy Law, s15. 1)("RE�+E � � oject Address (if different t mailing address) I. Application information - Please Print All Information /,,) 1 — r rJ r Property Owner's Na me r� tJ Z apt N Block # Property Owner's M ailing Address Poperty Location 16,Sechon . Ci State Zip Code Phone Number a.L�41_ !� 12 r` 2�G JCL ct. G ' {Circle cog II. Type of Building (check all that apply) T `�� N; R I E orddr ❑ 1 or 2 Family Dwelling - Number of Bedrooms _ , p Subdivision Name CSM Number g ❑ PublicXommercial - Describe Use { � State Owned - Describe Use I ❑City I _ ❑Village tTownship o 7 Jds�c j III. Type of Permits (Check only one box on line A. Complete line B if ap plicable) A. New System ❑ Replacement System ❑ Treatnient/Holding Tank Replacement Only ❑ Other Modification to Existing System B. ❑ Permit Renewal ❑ Permit Revision ❑ Change of ❑ Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Plumber Owner IV. Tjpe of POWTS System: (Check all that a ) it Non - Pressurized In- Ground ❑ Mound > 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil ❑ At -Grade ❑ Single Pass Sand Filter ❑ Constructed Wetland ❑ Pressurized In- Grouted ❑ Holding Tank ❑ Peat Filter ❑ Aerobic Treatment Unit ❑ Recirculating Sand Filter ❑ Recirculating Syn hetic Media Filter Leaching Chamber ❑ Drip Line ❑ Gravel -less Pipe ❑ Other (explain) V. Dispersal/Treatment Area Information: Design Flow (gpd) Design Soil Application Rate(gpdsf) Dispersal Area Required Of) Dispersal Area Proposed Of) System Elevation ��� 7 6 ; f r, d I VI. Tank Info Capacity in I Total Number Manufacturer Prefab Site I Steel Fiber Plastic Gallons Gallons of Units /� v Concrete { Constructed j Glass New Existing Tanks Tanks Septic or Holding Tank �� l' ` • � � � ........... Aerobic Treatment Unit Dosing Chamber l VII. Responsibility Statement- I, the undersigned, assume responsibility for tallation of the POWTS shown on the attached plans. Plumber's Na me (Print) Plumber's Si grtatur PRS Number Business Phone Number —3�� Plumber's Addre ss (Street, City, State, Zip Code) l 7d a 7tz; VIII. unt Department Use tW Approved Disapproved Sanitary Permit F� eludes Groundwater Date ssued uing Ag nt Signature ( ps) Surcharge Fee) O 0-0 L � Z ❑Owner Given Reason for Denial IX. Conditions of Approval/Reasons for Disapproval � ems— �" �.� CcJ�.e � /� � l�s��Q� -d►- -� I Attach complete plans (to the County only) for the system on paper not less tban 81/2 x 11 inches in size SBD -6398 (R.. 01103) ' w� �(r a I i Wisconsin Department of commerce SOIL EVALUATION REPORT Page / of 3 Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code Attach complete site plan on paper not less than 81/2 x 11 inches in size. Plan must S - Include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. percent slope, scale or dimensions, north arrow, and location and distance to nearest road. d 3 0 � 7� 9 D vi w b Date Please print all inform ,3�d e e y Persorw kdonnown you provide may be used (P +ae�C L w. s. t 04 (1) (m)). Li w l v 2 6 Pro "Owner Projerty Loca C - � O ►'� Lot SG.I 1/4 1/4 S ZT SON R /� E (or) G� Property Owner's Mailing Address - Lot Block # Subd. Name or CS&W u4 � r I Z City State Zip Code YV i - Q4fty ❑ Village (Sd Town - Nearest Road . �i. r,d.sG✓� I S* / ( S-1 J --ce IV - a bit (� New Construction Use: ® Residential / Number of bedrooms �_ Code derived design flow rate y GPD ❑ Replacement ❑ Public or commercial - Describe: Parent material 0C4 t,,) a S h Flood Plain elevation if applicable 14— ft. General comments and recommendations: S ys I e rr- e l c V, r) u e F Bod # Boring Pit Ground surface elev. �S yU f Depth to limiting factor / Z - C'� in. Soil ication Rate Horizon Depth Dominant Color Redox Description Texture Str Consistence Boundary Roots GPDM In. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. 'Eff #1 'Eff#2 -S ors S S Z •n rye ' S ! 4- J 98 - zo /v y /(y rh os rr• — • Z a# ° Boring ® Pit Ground surface elev. 9S: 30 ft. Depth to lirrriting factor / / in. lia" Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDM In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. '81#1 'Eff#2 a -1 Z 16 y 3 /L — S mct . $ . 8 Z )Z 0 Y I yry — s: amt ry , Effluent #1 = BOD > 30 < 220 mg1L and TSS >30 < 150 mgA- • Effluent #2 = BOD < 30 mg& and TSS < 30 mg& (Pl CST Name ease Print) - - Sig - CST MACAW S' s 3 3 Address Date Evaluation Concluded Telephone Number 1 Property Owner Parcel ID # Page Z of 3 # ❑ Boring 3 � ® Pit Ground surface elev. 95'. (oo ft. Depth to limiting factor in. Rate Horizon Depth Dominant Color Redox Dw""on Texture Stricture Consistence Boundary Roots GPDM in. Munsel Qu. Sz. Cont. Color Gr. Sz. Sh. •Ef1#1 'EB#2 Z /o - 40 r" /A / c $ ry\ — — Boring # Q Borin Ground surface elev. ft. Depth to limiting ❑Pit P n9 factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDM in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 •Eff#2 F -1 Ong # ❑ Boring C1 Pit Ground surface elev. ft. Depth to limiting factor in. Sal AD011cation Rate Horizon Depth Dominant Color Redox Description. Texture Structure Consistence Boundary Roots GPD/ff: in. Munsell Qu. Sz. Court. Color Gr. Sz Sh. •Efr#i I •Eff#2 Ef fluent #1 = BOD > 30 _< 220 mglL and TSS >30 < 150 mg/L • Effluent #2 = BOD c 30 mg1L and TSS < 30 mglL The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608- 266 -3151 or TTY 608 -264 -8777. seo-43wOtAM) tape 3 >1 ,V. Ou RR ,o vfi 95. • �a � - qS• 4e r� 0 • � g -3 E � J 0 0 °� d; � cod B in 0'7C / VC- S v f S33 Safety and Buildings Division CourttY S ry 201 W. Washington Ave., P.O. Box 7162 C �S Ct�ttsii'� Madison, WI 53707 - 7162 Site Adder s3v p'L 3.3( z� /21 } ewT f3rLooK Qo�4n N T"-t{ D@ nrtm @nt Of Co mm erce Permit Number Sanitary Permit Application q0,S - I S In accord with Counn 83.21, Vru. Adm. Code, personal infottttation You provide ❑Check if Revision —.V be used for primy Law, #15.04(l m State P lan I.D. Num ber I. Application Inf0rIItuW0n - Please Print All Information Parcel Number Property Owner's Name ve Q' ® -�Q fG — �6 aQ'lJ Property location Property Owner's Mailing Addreaa "; S .2 T N, 4; ' ( y lI lot Number Block Number City, State 2� Zip Code Phones um J ST. CROIX COUNTY Subdivision Name CSM Number ZONING OFFICE e N Sl U. Type of Building (check all that apply) 6k S OCnry OI or 2 Family Dwelling - Number of Bedrooms 3 {' I't" Owlage 0 Public/Commercial - Describe Use o ?- Nearest Road 0 State Owned `/ �,,� • .. ,�. �. p Q � � �� xo 2 III. Type of Permit: (Check ody one box on Une A (numbering scheme for internal use). Complete line B iP applicable) A 0 Replacement of 6 0 Addition to For County use 1 O Naw 2 ❑ Itaplaoemant System 3 S stain Tadt OW Existing stem Date Issued B. 0 Check if Sutitaty Pasant Previously Issued Permit Number IV. Type of Permit: (Check all that apply)(numbering scheme is for internal use) 210 Mound 47 0 Sand Filter 5o O Constructed wetland 44 Non - Presatriud 1n-C#rouad Si O Drip Line 22 0 p m l 410 Holding Tank 48 0 Single Pass 45 0 At- (grade 46 O A Treaunent Unit 49 [11 R itcula 3011 Oriner n V. Area Information: 2 A b 4 F Percolation oil load Race stem Elevaaoa Final tirade Design Flow FPO Diapersd Area Dispe APP Elevation g Fro (OWL cials.mays /Sq.Pt.) (Min.Mclt) LSD 4? Y3 e7 r1� �►Y, o VI. Tank Info Captivity is Total Number Manufacturer Ptefab Site Steel Fiber Plastic Gallons Gallotu of Tanks Concrete Constructed Glass New Bxistiaa Tanks Tmka Sept a of lloidttB Tank V k- , VII. R iii Statement 1, the undersigned, assume resP tY for at the POWTS shown oa the attached Plumber's Name (Prins) Plumber's Signature RS Number Business Phone Number Plumber's Address (Street, CO. state, Zip Code) 7d Gd S'd.✓ �. " . O' G VIII. Count /De t Use quiz Permit Pee (includes Groundwater Date Issued Issuing Agent Signature (No stamps) Sanitary Approved 0 Disapproved Surcharge Fee) dp (3 owner Given In" Adverse Determination IX. Condi d A proval)Reasons for Disapproval A-a ea net ka than 814 z 11 inches In size (1 -oQb[ti t9 vl q 0. 4t �, .�,,, _ the Couat7 od7) 4A SYS `� ►n 6 y� C 8�� SBD -6398 {Rv45 /0 : , �"". __ —_ . 93 t>tC� S? k GL7s-6,d s�U1%'Sw Y� 33� r �z ;v A /9' ` a ' t s2�A d Q D•� p D cP L ro il S . Gl�s r h 4�D , � .2 ��� � •�8j n �z4A < - •rd rS �rT�/ C 4 S AP hr � � isconsi SOIL AND SITE EVALUATION REPORT Page 1 of 3 Labar and Human Relations Division of Safety 8 Buildings in accord with ILHR 83.05, Wis. Adm. Code f COUNTY Attach complete site plan on paper not less than 8 1/2 x 11inches in size. Plan must include, but St. CRoix not limited to vertical and horizontal reference point (8M) ection and % of slope, scale or PARCEL I.D. # dimensioned, north arrow, and location and distance to "nearesf ror d 030- 1096 -10 -000 APPLICANT INFORMATION - PLEASE PRIN'FAf f )NFORM'A�JON REVIEWED BY DATE PROPERTY OWNER: PROPERTY LOCATION Janet Dilts GOVT. LOT SW 1 /4SW 1i4,S 32 T 32 N,R lg !x(or) W PROPERTY OWNER':S MAILING ADDRE$$ LOT # I BLOCK # I SUBD. NAME OR CSM # 1218 Trout Brook Rd. N rr CITY, STATE ZIP W . U ❑CITY ❑VILLAGE TOWN NEAREST ROAD Hudson, WI. 54016 . -915) 54�i St. Joseph Trout Brook Rd. N. [A New Construction Use Pc] Residential/ rooms 4 [ ] Addition to existing building I ] Replacement [ ] Public or commercial describe Code derived daily flow 600 gpd Recommended design loading rate .7 bed, gpd /ft .8 trench, gpd /ft Absorption area required 858 bed, ft 750 trench, ft Maximum design loading rate .7 — bed, gpd /ft .8 trench, gpd /ft Recommended infiltration surface elevation(s) 94.50 ft (as referred to site plan benchmark) Additional design / site considerations trenches 4.00' below grade Parent material outwash Flood plain elevation, if applicable na ft S = Suitable for system CONVENTIONAL MOUND IN- GROUND PRESSURE AT-GRADE SYSTEM IN FILL HOLDING TANK U = Unsuitable for s stem ®S ❑ U ®S ❑ U I ®S ❑ U 12 S ❑ U ® S ❑ U ❑ S 13U SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft .................. in. Munsell Qu. Sz. Cont. Color G Sz. S h. Bed Trench ................. 1 1 0 -9 10yr3 /3 none sil 2msbk mfr cs 2c .5 .6 S 2 9 -32 10yr4 /4 none sci 2msbk mfr gw lm .4 .5 Ground 3 32 -11 7.5yr4/6 none co s Osg ml na na .7 .8 elev. li g_g_,_� ft. (o 0 Depth to limiting factor +110" c fo dos Remarks: non - contiguous 20 x 50" sil lens in H -3 Boring # 1 0 -11 10yr3 /3 none sil 2msbk mfr gw 2m .5 .6 S 2 2 11 -30 10yr4 /4 none sicl 2msbk mfr gw lm .4 .5 3 30 -11 7.5yr4/4 none co s Osg m1 na na .7 .8 Zund elev. 4 98 ft. Depth to limiting �$ factor +110" Remarks: CST Name: -- Please Print Gary L. Steel Phone: 715- 246 -6200 Address: 1554 200th. Av . ew Richmond WI 54017 Signature: Date: 11 -25 -2000 CST Number: m02298 1 PROPERTYOWNER Janet Dilts SOIL DESCRIPTION REPORT Page 2 "'of 3" PARCEL I.D. # 030- 1096 -10 -000 • Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trerxh 1 0 -8 10yr3 /3 none sil 2msbk mfr gw 2c .5 .6 �- 2 8 -23 10yr4 /4 none sicl 2msbk mfr gw lm .4 .5 Ground 3 23 -90 7.5yr4/4 none co s Osg ml na na .7 .8 elev. 9 6.5 ft. Depth to limiting factor Remarks: Boring # 1 0 -8 10yr3 /3 none sil 2msbk mfr gw 2m .5 .6 S 4 2 8 - IOyr4 /4 none sicl 2msbk mfr gw lm .4 .5 3 28 -96 7.5yr4/6 none co ss Osg ml na na .7 .8 Ground elev. 9 5.0 ft. — Depth to - limiting factor +96" Remarks: Boring # 1 0 -9 10yr3 /3 none sil 2msbk mfr gw 2c .5 .6 r 5 ?> 2 9 -24 10yr4 /4 none sicl 2msbk mfr gw lm .4 .5 3 24 -86 7.5yr4/6 none co s Osg ml na na .7 .8 Ground elev. 9 5.3 ft. Depth to limiting factor +86" Remarks: Boring # 13 Ground elev. i ft. Depth to limiting factor Remarks: SBD- 8330(8.05/92) I e . STEEL'S SOIL SERVICE Gary L. Steel 1554 200th Ave. CSTM2298 sw4sw4 1 Janet Dilts s32- T32N -R19w New Richmond, WI 54017 MPRSW -3254 town of St. Joseph 715 246 -6200 lot #5 -csm 1 ,, =40' nail in Norway pine C el. 100.00 nail in Norway pine @ el. 95.40 �. 10 51� "�e �v Gary L. Steel 4— 25 -2000 Private Onsite Wastewater Treatment System Management Plan Septic Tank And Gravity in- Ground Soil Absorption Component Pursuant to Comm 83.54 Wis. Adm. Code each Private ©nsite wastewater Treatment System (POWTS) shall include information and procedures for maintaining the sys tem within the parameters of Comm 83 and 84, and the conditions of approval by the department, agent, or governmental unit. The approved plans and permits for system are on file at the county zoning or health department. This management plan complies with Comm 83.54, Wis. Adm. Code, and the In -Ground Soil Absorption Component Manual for Private Qnsite Wastewater Treatment Systems SBD- 1 0567 -P (R.6I99). Table 1: System Des' n S cifications Sanit Permit Number l i Number of Bedrooms 3 Des n Flow - Peak ( pd) Estimated Flow - Average (q pd) +� Sep tic Tank Capacity ( Lprcv i:. Soil Absorption Corn anent Size (f:�) Type of Wastewater Domestic Table 2: Sail Absorption Component - Limits of Reliable O *ration Se tic Tank Component Soil Absorption Component Desi n Flow - Peak ( pd) L 60, ^118 Maximum influent Particle Size (in) - 220 Maximum BQD (m IL) Maximum TSS (N LL)) 150 L r_- Table 3: Maintenance Schedule Se laic Tank Inspect and /or service once every 3 years Nutlet Filter Inspect once a year and clean at least once every 3 years Soil Absor tion Corn orient inspect once every 3 years ptic Tank The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Stats, The contents of the septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code (Servicing Septic or Holding Tanks, Pumping Chambers, Grease interceptors, Seepage Beds, Seepage Pits, Seepage Trenches, Privies, or Portable Restrooms). The operating condition of the se tic tank and outlet Ater sha "i be assessed at least once every 3 years by inspection. The utiet filter h ats be cleaned as necessary to ensu proper operation. The filter cartridge should not be removed unless provisions are made to re ain so in the tank that may slough off the filter when removed from its r s enclosure. If the i �- iMaragern'nt Plan for a Septic Ta ^K aMa Sci; Adsorption Corr►porent ilter is equipped with an alarm, the filter ®hall be serviced if the eiar+' , is motivated cxaMirruovs lrtermftrtt filter alarm may Indicate surge flows or lift ImponditV continuous alarm, The se a tank shall have Its oon� MMCVfd Who the+ VOiume of scum end sludge int t at ta � re not ren�+o i of the tank. If the Con�rrte of the tank a exaeads '1f3 the liquid vo ume next $ervers We of an assessment, rn>slnInance personnel Khali advise " ear of when ate► needs to be perfotrned to Mai AIM 1e41 than maximum arum and sludge aoamnulatlon in ttte tank. Manhole risers, access risers and covers should be inspected for water tightnsa swmdnese. A=m openings used for soNas and assessment shell be seaied w ft # m Ig ht upon ust be taplaosd� ,Exposed s4cese op tm completion of service. Any opening d"n* unsaurtdi de +iO or sulk � f o lk" rn �y es�l +� g reater than 11-11116 In dktfr*tr shall be an e+lfsctve iWWM9 device to Prevent aooldentai or QmOuthorised entry Ind the ttnk. No afro should *atw a "POO or odrsr tna&Wt tu' haldhg tank lW In fWt j"er with D stondrrda (W any raetseen ,without bei�rgr Qom � �o tiJa� , � odlEer tlrg I cc~ spase. The i�� artd naawt of e ON # of h*Mft btnlr MY �M low f � pwm t InW*r of MO "k mey be Tank abandonment shall be in sooardanoe WM Comm 83.33, Whiz, Adm. Code when the tank Is no larVer used aer a POWT3 componsnt. 10 AN The soli absorp#ion carmponent serving this structure is designed to accept domestic wastewater fir m a moldental WAY. The lif to of opsnttlon of 'his Component are ahown in Table Z, "r and tiffY The ►ongevlty of a 8011 absorption component dspwnds greasy on Pr ood Was mainterianos, and sy�stern use within or below ft ilMits of reilabla e ado+ , t3 op oonaaeervgton practices by all COMPOn and the i nsW114110n of WOW Ocnserving plumbing fixtures aflr key seaters in extending the usefu life Of Thee salt absorption oornportant`e operator must be assessed by inspection at least MY. in once every three years. The InsPectton shall include noording the l+rveis of pondi d s barge the obSVVgdon pipes, and a vlsus i nsPOO#On for any rfa evidence of suca seepag fyorn the c nWowt. Or, etseply:toping sites, areas of erosion ehould be identifled and reporl#d to to own for hair. The surisoe dis charge of domestic wastewater or sewiKe from the system Is prohibited and correlde»d a hurnen haith tttcard l o on ccmPonent ahouid be avoided particularly o around at aver the sal abs rptl 0 Traitl t may lea O f snow CbVer over the Wmpenest during winWr months. The Compaction of removal o but Is MCA Or hydraulic failure by freezing. This type of f ail ure is usually tam; o r &'V' b tit IR I +on ove this impoe IWO to repair until weather nditlons Improve. In gertern component Will reduce diffusion of owpn into the soil and dispenst opal, which may lead to more lrlt>erse, and ea rlier, organic clogglny of the soli. 2 Management Plan for a Septic Tanis and Soil Absorption Component Plantings of sleep- rooted tress and shrubs directly over of within ten het of the component should be avoided Since root intrusion into the component may obstruct wastewater flow. Contingency Plan jr,, the event of system failure, a new system could be installed in an alternate area. With the installaVon of a diverter valve, the existing system could also be reused after a period of three to four years. It is the property owners responsibility to maintain the alternate area free from any planting of trees, shrubs, etc. in case of failure of the original system, the alternate area will be needed. If any trees shrubs, etc. have tram planted on titre Comets area, they will have to be removed at property owners expense. It alternate area is destroyed, there are other alternative systems that can be used, in which, oouid result ;n added sxperse to the property owner, Any tank abandonment shall be done in accordance with WIN. Code 63.33. Any questions regarding this oode, please contact your local Zoning Office or contact the installing plumber. CAA 6ts ) 3,g to w LA to% 4 c.� �t..re -. �o.�,..,,tt., �' � u�, ecY+ b y � s� �, �' 1 �� 3'� b • � (� S ,c�'vad 7 ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND f OWNERSHIP CERTIFICATION FORM Owner/Buyer ° CU6 2 E _D @ C(+S0n Mailing Address )S fin. & �L�h; +P, Bear La ue, kU SS/o Property Address I rd d rx '4_�d(Ad I)O (Verification required from Planning Department for new construction) City /State Parcel Identification Number 0,30 - 1 OIL Q� LE GAL DESCRIPTION Property Location 5U) 1/4, '_ '/4, Sec. T -Rj_W, Town of 15f. 05ep 6 . Subdivision , Lot # Certified Survey Map # �� fi s� ,Volume ,Page # �Z3Z Warranty Deed # / , Volume ig9j , Page # 391 Spec house ❑ yes X no Lot lines identifiable 0 yes ❑ no SYSTEM MAINTENANCE Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. The property owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on -site wastewater disposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. I /we, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St, Croix County Zoning Office within 30 days of,th thr Fe ;wxpiration..date. SIGNATURE OF APPLICANT DATE OWNER CERTIFICATION I (ive) certif th all statements on this form are true to the best of my (our) knowledge. I (we) am (are) the owner(s) of the pr5e , des R -d ove, by virtue of a warranty deed recorded in Register of Deeds Office. r ATURE O APPLICANT DATE * * * * ** Any information that is mis- represented may result in the sanitary permit being revoked by the Zoning Department. * « * * ** "* Include with this application: a stamped warranty deed from the Register of Deeds office a copy of the certified survey map if reference is made in the warranty deed i r Vol. 1 821 PAa 381 STATE BAR OF WISCONSIN FORM 2 - 1999 IS 6.91 52 Document Number WARRANTY DEED KATHLEEN H. W A L S H F,EGISTER OF DEEDS ciT. CROIX CO., WI This Deed, made between a one -half interest to Jeanette H. Dilts, or RECEIVED FOR RECORD successor trustee, as trustee of the Dilts Family Trust funded July 29, 1999 and a one -half interest to Jeanette H. Dilts, or successor trustee, as trustee 01 -23- 2002 4:00 PM of the Jeanette H. Dilts Survivor's Trust funded July 29,1999; both such WARRANTY DEED trusts have been created under the Claire H. and Jeanette H. Dilts EXEMPT # Revocable Trust dated February 20, 1997; the two half interest shall be CERT COPY FEE: held as tenants in common Grantor, and Steven and Deborah Knudtson, COPY FEE: husband and wife Grantee. TRANSFER FEE: 114.00 RECORDING FEE: 11.00 Grantor, for a valuable consideration, conveys and warrants to Grantee PAGES: 1 the following described real estate in St. Croix County, State of Wisconsin (if more space is needed, please attach addendum): A parcel located in part of the SW 1/4 of the SW 1/4 of Section 32, T30N, R1 9W Town of St. Joseph, St. Croix County, Wisconsin legally described as filed January 8, 2002, as Document #667582 in V o_115, Recording Area of Certified Survey Map, p &e 423 in the office of the register of deeds for St. Croix County Wisconsin Name and Return Address 7 n � a C t S ^' • 13'76 /4 vt c k /c1% / AA , ) 030 - 1096 -10200 Parcel Identification Number (PIN) This is homestead property (is) Exceptions to warranties: easements, restrictions and reservations, if any, of record. Dated this day of January 2002 eanette H. Dilts, trustee of Dilts Family Trust ; #nctte H. Dilts, trustee of the Jeanette H. Dilts Survivor's Trust AUTHENTICATION ACKNOWLEDGMENT Signature(s) Jeanette H. Dilts, trustee of the Ddts Family Trust and Jeanette STATE OF ) H. Dilts, trustee of the Jeanette H. Dilts Survivor's Trust ) ss. County ) authenticated this ( day of January _ 2002 Personally came before me this day of the above named • Lois A. Murray TITLE: MEMBE TATE BAR OF WISCONSIN (If not, to me {mown to be the person(s) who executed the foregoing authorized by § 706.06, Wis. Stats.) instrument and acknowledged the same. THIS INSTRUMENT WAS DRAFTED BY Lois A. Murray, Estreen & Ogland 304 Locust Street, Hudson, WI 54016 Notary Public, State of My Commission is permanent. (If not, state expiration date: (Signatures may be authenticated or acknowledged. Both are not necessary.) ) ' Names of persons signing in any capacity must be typed or printed below their signature. Information Professionals Co., Fond du Lac, WI STATE BAR OF WISCONSIN 800 -655 -2021 ' t 16 Continued CERTIFIED SURVEY MAP LOCATED IN PART OF THE SW1 /4 OF THE SW1 /4 OF SECTION 32, T30N, R19W, TOWN OF ST. JOSEPH, ST. CROIX COUNTY, WISCONSIN. SURVEYOR: PREPARED FOR: DOUGLAS J. ZAHLER JEANETTE DILTS S & N LAND SURVEYING, INC. 1218 TROUT BROOK RD. N. 2920 ENLOE STREET HUDSON, WI 54016 HUDSON. WI 54016 7r SURVEYOR'S CERTIFICATE I, Douglas J. Zohler, Registered Wisconsin Land Surveyor, hereby certify' that by the direction of Jeanette Dilts, I hove surveyed, divided and mopped port of the SW1 /4 of the SW1 /4 of Section 32, T30N, R19W, Town of St Joseph, St. Croix County, Wisconsin; described as follows: Commencing of the Southwest corner of said Section 32; thence N89'46'13 "E 400.68 feet along the south line of the Southwest Quarter of said Section 32 to the point of beginning; thence N01'02'47 "W 404.93 feet along the east line of Lot 4 of a Certified Survey Mop recorded in Volume 14, Page 3902, at the St. Croix County Register of Deeds Office; thence N88'57'13 "E 349.96 feet along the centerline of Trout Brook Rood North; thence S01'02'47 "E 409.92 feet; thence S89'46'13 "W 350.00 feet along said south line of the Southwest Quarter to the point of beginning. Above described parcel contains 3.273 Acres (142,584 Sq. Ft.) Subject to right —of —way for Trout Brook Rood North and all other easements, restrictions and covenants of record. I also certify that this Certified Survey Mop is a correct representation to scale of the exterior boundary surveyed and described; that I hove fully compiled with the provisions of Chapter 236.34 of the Wisconsin Statutes and the Land Subdivision Ordinance of St. Croix County and the Town of St. Joseph in surveying and mapping some. --- i2 = 12 -0 l Douglas J oh R S 2145 OF W/S S & N Land S veying �Q.��ri c02 2920 Enloe St. C-0 DOUGLgS J. N Hudson, WI 54016 * ZAHLER Z S -2145 HUDSON, WIS. $(f F�4 GENERAL NOTICE Each parcel shown on this map is subject to State, County and Township lows, rules and regulations (i.e., wetlands, minimum lot size, access to parcel, etc.). Before purchasing or developing any parcel contact the St. Croix County Zoning Office and the appropriate Town Board for advice. THIS INSTRUMENT DRAFTED BY: WILLIAM KANE JOB NO. 6100 -01 DATE: 09/05/2001 REVISED: 12/17/2001 SHEET 2 OF 2 SHEETS Vo1.15 Page 4232 667582 0 1 15 �• IA G E 4232 K THEEM H. WALSH 16 ST O . CROIXCO RECEIVED FOR RURD 01-08 -2002 1:30 PM cn COPY FEE: 3.00 _ N O y RECORDING FEE: 13.00 Z Sl vN�o C o PAGES: 2 A - .� -9�. cn o c� No -� m z;0 M c O t � Zm < � no O O r - 0> Om z A c c oz<- m �-ig v m O4nN.,,�D opN O �j m ;8 m •• 0 0 '11 BEARINGS ARE REFERENCED TO THE -4 Z O � ; O SOUTH LINE OF THE SW1 /4 OF SECTION 0 0 m N�S� z o M 32, ASSUMED TO BEAR S89'46'13 "W c " i Z r 11 1 N 1 1 D i �� Io $ I i 1 _ __ O z S , m [�oi! D[� D - - -- o -- 1 0 to 1 O m T i o 11 i C= --- ----- ----- - - - - 1 ^ � ^�� 1 - -- I 1 1 0 I w m N01 °02'47 "W 404.93' 11 d ; I@ Z iP 9) 371.93' 3.00 I °a iQ O P 10 O o O y I v ao 1O i Ga 1 (JV > , I� Q N Z ul Ic I 1 a IP nn^^ (n IPM I O Vv I I I m I in in l0 1 i� p W ° ° w cn I 1 I t0 to w �.� w W I� I I p 10 I w `�11JI 12 I W 0 loll ^ Z w D D M m 1 n_� „ u' IC511uuu m -' M 0 , 1 I lO Io O m - CA I�I�IQI C? i� � W �cnncn X �d ' O 1O - -,a I • M I 1�� I �nO�n/� 2 M V1jV� I I lJ l 33' 33' 10 9 1 I ;,., i O I�1 - 376.97 33.00 IV 1� N I�1 I J�U I J S01 0 02'47 "E 409.92' Nom I � � MG`Jp�G°J44GD dQGvJD` cn U) M m� o -� P a Z C4 0 to 0 O n Z -0 O m d � V1 ^;0 N N Tl C V J f�'1 -DC O D p ? nC M N TI N p -< m� 0 r - > z � --1 S C O 2 O ° N C 0) ® - m c � m �_ � ;0 -4 — ZZ Cn� mZ S D 2 ;0 I 1 D'O Or � m r. Z� Oo OTC D m Wm �'I n 0 T -a r m vC -c mm � ZC�D I n m N cn --n z� r�i a Z Z V On ; ' r O D 0 SHEET 1 OF 2 SHEETS Vol. 15 Page 4232